Migrant Health Joint Strategic Needs Assessment -

The Migrant Population Across Cambridgeshire & Peterborough: Data, views and issues

Dr Fay Haffenden, Consultant in Public HealthRyan O’Neill, Advanced Public Health Analyst, PCC

Sara Dunling-Hall, Specialist Registrar in Public Health

The Migrant Population Across Cambridgeshire & Peterborough: • Data: what data do we have and what does the data tell us? • What do we know about the views of migrants? • What issues are we aware of from migrants, local populations,

service providers and other stakeholders? • Particular issues for Refugees and Asylum seekers?

London

South East

East of England

North West

Yorkshire and The Humber

East Midlands

Scotland

South West

West Midlands

North East

Wales

Northern Ireland

0.0 5.0 10.0 15.0 20.0 25.0 30.0

26.3

11.8

10.0

9.8

7.0

7.0

6.8

6.2

6.0

3.4

3.2

2.4

Proportion of total UK Immigration (%)

Proportion of long-term international immigrants to UK, 2012

Source: Office for National Statistics, 2012

England East of England Cambridgeshire Cambridge City East Cambridgeshire Fenland Huntingdonshire Peterborough South Cambridgeshire0.0

50.0

100.0

150.0

200.0

250.0

300.0

350.0

2010 2011 2012 2013 2014

Rate

per

1,0

00 T

otal

Pop

ulati

on

Non-UK Born Population, 2010-2014, Crude Rate per 1,000 Total Population

Source: Office for National Statistics, 2014

England East of England Cambridgeshire Cambridge City East Cambridgeshire Fenland Huntingdonshire Peterborough South Cambridgeshire0.0

10.0

20.0

30.0

40.0

50.0

60.0

2010 2011 2012 2013 2014

Rate

per

1,0

000

Tota

l Pop

ulati

on

Non-UK Born NINO (National Insurance) Registrations, 2010 – 2014, Crude Rate Per 1,000 Total Population

Source: Office for National Statistics, 2014

England East of England Cambridgeshire Cambridge City East Cambridgeshire Fenland Huntingdonshire Peterborough South Cambridgeshire0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

2009-2010 2010-2011 2011-2012 2012-2013 2013-2014

Inflo

w ra

te p

er 1

,000

0 po

pula

tion

Long-Term International Migration Inflow Rate, 2009-10 – 2013-14, Crude Rate per 1,000 Total Population

Source: Office for National Statistics, 2014

England East of England Cambridgeshire Cambridge CityEast Cambridgeshire Fenland Huntingdonshire Peterborough South Cambridgeshire0.0

100.0

200.0

300.0

400.0

500.0

600.0

2010 2011 2012 2013 2014

Rate

per

1,0

00 b

irths

Births to Non-UK Born Mothers, 2010-2014, Crude Rate per 1,000 Births

Source: Office for National Statistics, 2014

Economic Status of Non-UK Born Residents, 2011

England East of England Cambridgeshire Cambridge City East Cambridgeshire Fenland Huntingdonshire Peterborough South Cambridgeshire0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Employed UnemployedLong Term Sick, Disabled or Economically Inactive Due To Caring Responibilities In EducationOther

Source: Census, 2011

QuintileCambridge City East Cambs Fenland Huntingdonshire Peterborough South Cambs

1 = 20% of Schools with Highest % of EAL Students 15 2 6 3 36 32 16 4 3 9 19 133 2 10 6 13 9 244 0 11 15 18 5 15

5 = 20% of Schools with Lowest % of EAL Students 1 8 9 26 6 15

Area

Cambridgeshire & Peterborough Schools – Quintiles Assigned by % of Children who Speak English as an Additional Language

Source: Cambridgeshire City Council/Peterborough City Council Schools Data

Cambridgeshire & Peterborough Schools – Ranked by % of Children who Speak English as an Additional Language

Blue = Cambridge City Yellow = East Cambs Purple = Fenland Red = Huntingdon Green = Peterborough Magenta = South Cambs

Source: Cambridgeshire City Council/Peterborough City Council Schools Data

Qualitative Data: What Issues and views are we aware of?• Demography • Local Health Status and Health Service Usage• Education• Housing• Employment• Wellbeing, Lifestyle & Social Cohesion• Crime• Key Documents/resources

Qualitative Data: Cambridgeshire & Peterborough Migrant Survey 2015 – 116 Responses

6.0%

17.2%

47.4%

29.3%

Age of Respondents

<18 18-30 31-45 46-67

33.6%

66.4%

Gender of Respondent

Male Female

Qualitative Data: Cambridgeshire & Peterborough Migrant Survey 2015 – 116 Responses

14.7%

24.1%

31.9%

7.8%

0.9%

18.1%

Respondent Country of Origin

Czech Republic Latvia LithuaniaPoland Portugal Slovakia

2.6%

6.9%

37.9%

52.6%

Respondent Tenure in UK

<3 Months 3-12 Months >1 Year - < 5 Years >5 Years

Qualitative Data: Cambridgeshire & Peterborough Migrant Survey 2015 – 116 Responses

30.2%

36.2%

20.7%

2.6% 6.0%4.3%

Respondent Living Arrangements

Living with partnerLiving with other family membersLiving in a shared house/flatLiving in a shared roomLiving with 3 or more other people who are not familyLiving in other accommodation

93.1%

6.9%

Respondent GP Registration Status

Registered with a local doctor/GP Not registered with a local doctor/GP

Qualitative Data: Cambridgeshire & Peterborough Migrant Survey 2015 – 116 ResponsesWhat are some of the best things about living in

the UK?

• 45% of respondents mentioned employment opportunities, regular/fair pay and economic security.

• 16% mentioned people’s attitudes towards community cohesion, civic pride etc.

• 11% mentioned education and opportunities for children and young people.

What are some of the worst things about living in the UK?

• 29% of respondents mentioned healthcare, including difficulties obtaining GP appointments outside of their working hours.

• 21% mentioned difficulty engaging with public services providers, bureaucratic processes and a lack of interpreters.

• 13% mentioned pollution/unclean environment.

Demography: What Issues and views are we aware of?• Very diverse groups and needs: • Change in demographics in Fenland: Increased number of Lithuania,

Hungarian and Portuguese, previously Polish and Latvian - now being recruited from more rural areas (decreased literacy etc)• Majority of migrants come for shorter periods, but intentions change:

More migrants now settling – less high needs - bringing families over• Churn: In Wisbech thought to be around 10,000 migrants with an

annual churn of 4,000 (new people coming in constantly)• EU populations – generally quite resourceful – want to improve things

– some learn English very quickly - small number of support agencies available– suggests resilient and self-sufficient populations

Local Health Status and Health Service Usage: What Issues and views are we aware of?• Understanding of NHS system• Access to health services• Language• Cultural Issues• Trust• General Issues/Services• Impact of employment, housing and lifestyles

Children and Education: What Issues and views are we aware of?

• Understanding of UK educational system: access and expectations• Proportions of EAL in certain schools• Special needs • Children in Need• Bullying and Safeguarding • Achievement levels?• Impact on local populations

Housing: What Issues and views are we aware of?• Houses of Multiple-Occupancy• Links to employment -Shared beds• Homelessness• Entitlement to benefits• Social housing• General housing shortage• Barracks / privately owned migrant camps

Employment: What Issues and views are we aware of?• Worker Exploitation – See Crime chapter notes as well• Language• Work ethic strong – become workers of choice for local employers• Gang-masters now run ‘gangs’ from one country – has implications for social

cohesion. Many gangmasters reputable (approx. 70%) but some which are far from it. Gang-masters tend to be recruiting more vulnerable people who can’t read/write in their own languages let alone English.• Tend to get migrants working below skill levels • Zero hours contracts increasingly being used – stops access to benefits • Health care workers shortage

Wellbeing, Lifestyle & Social Cohesion: What Issues and views are we aware of?• Lifestyle Behaviours• Alcohol• Smoking• Mental Health• Other: More normal to breastfeed in Eastern European culture; Drugs do not

seem to be an issue with migrant populations across Wisbech• Social Cohesion/integration with UK born population - ‘fairness issues’ -

Migrant population not involved in decision making – no local representation - English levels - discrimination and negative attitudes - spousal visas - lack of family networks - Alcohol issues create angst with local populations

Crime: What Issues and views are we aware of?• Exploitation: Operation Pheasant • Shared beds – linked to shift patterns – can result in alcoholism on

streets (no where to go and need to keep warm) + gangs ‘hanging around’ on streets• Domestic Violence: Results in increase in numbers of children going

into care - spousal visas • Safeguarding• As a result of last JSNA a specialist post was created to support

Eastern Europeans suffering from DV

Refugees & Asylum Seekers: What Issues and views are we aware of?• Asylum seekers: forced to leave v migrants: choose to leave • 4% of migrants • Can’t work while asylum claim assessed • Traumatic background - Post Traumatic Stress and mental health -

Loss and injury of family and friends - Loss of possessions and control of lives • Unaccompanied minors

Key Documents/resources

• Migrant Workers – Accessing Healthcare in Norfolk (Commissioned by Healthwatch Norfolk and Norfolk Community Relations and Equality Board) – Work carried out with KLARS clients but their issues likely to be across the board• KLARs – A Self Evaluation of New Communities Initiative, Phase 2 –

A Service review for KLARs services• http://migrationobservatory.ox.ac.uk